活血解毒化痰法对浆细胞性乳腺炎患者的Hs-CRP、PRL及细胞因子IL-1β、IL-6、TNF-α的影响

发布时间：2018-05-25 09:37

本文选题：浆细胞性乳腺炎 + 活血解毒化痰法　；参考：《安徽中医药大学》2015年硕士论文

【摘要】：1目的(1)观察浆细胞性乳腺炎患者的Hs-CRP、PRL及细胞因子IL-1β、IL-6、TNF-α的变化,研究活血解毒化痰法对上述指标的干预作用,并探讨中医活血解毒化痰法治疗本病的机制。(2)观察活血解毒化痰法治疗浆细胞性乳腺炎的临床疗效。2方法选择42例浆细胞性乳腺炎患者随机分为治疗组和对照组,治疗组24例予以活血解毒化痰法联合中医外治法治疗;对照组18例予以抗生素及激素治疗联合中医外治法治疗。(1)疗效评估:观察治疗前后中医证候评分及临床疗效。(2)测定血清中超敏C-反应蛋白(Hs-CRP)、催乳素(PRL)水平,治疗前、治疗2周后各测一次。(3)采用酶联免疫吸附法(ELISA)检测细胞因子IL-1β、IL-6、TNF-α的水平,治疗前、治疗2周后各测一次。3结果(1)临床疗效评估:①中医证候积分:与治疗前比较,2组患者治疗后的中医证候积分均有明显下降,差异有显著性统计学意义(p0.01),治疗后2组间比较,治疗组优于对照组,差异有显著性统计学意义(p0.01)。②临床疗效:中药活血解毒化痰法联合中医外治法治疗浆细胞性乳腺炎临床疗效的总有效率为91.67%,西药联合中医外治法治疗浆细胞性乳腺炎的总有效率为83.33%,经非参数检验,p0.05,无统计学意义。(2)实验室指标评估:①与治疗前相比,2组患者治疗后Hs-CRP、PRL水平均有明显下降,差异有显著性统计学意义(p0.01),2组患者治疗后Hs-CRP、PRL均值比较,p0.05,差异无统计学意义。②与治疗前相比,2组患者治疗后IL-1β、IL-6、TNF-α水平均有明显下降,差异有显著性统计学意义(p0.01),2组患者治疗后TNF-α均值比较,p0.05,差异有统计学意义,2组患者治疗后IL-1β,IL-6均值比较,p0.05,差异无统计学意义。③浆细胞性乳腺炎患者在脓肿期细胞因子IL-1β、IL-6、TNF-α的水平显著高于炎性肿块期IL-1β、IL-6、TNF-α的水平,差异具有显著性统计学意义(p0.01)。4结论(1)浆细胞性乳腺炎患者血清Hs-CRP值可作为观察本病病情变化的参考值之一。(2)浆细胞性乳腺炎患者血清PRL的水平升高与本病的发病存在相关性。(3)浆细胞性乳腺炎患者血清细胞因子IL-1β、IL-6、TNF-α的水平在脓肿期明显高于炎性肿块期,患者血清细胞因子IL-1β、IL-6、TNF-α的水平可能与炎症反应的程度有关。(4)中医活血解毒化痰法拟方可减轻浆细胞性乳腺炎患者的临床症状,其机理可能与其降低患者血清IL-1β、IL-6、TNF-α水平有关。
[Abstract]:Objective 1) to observe the changes of Hs-CRPU PRL and cytokine IL-1 尾 -IL-6 TNF- 伪 in patients with plasma cell mastitis, and to study the effect of activating blood circulation and detoxification and resolving phlegm on the above indexes. To explore the mechanism of activating blood circulation and detoxifying and removing phlegm in treating this disease. (2) to observe the clinical curative effect of activating blood circulation and detoxifying phlegm in treating plasma cell mastitis. Methods 42 patients with plasma cell mastitis were randomly divided into treatment group and control group. In the treatment group, 24 cases were treated by activating blood circulation and detoxifying phlegm combined with external treatment of traditional Chinese medicine. In the control group, 18 cases were treated with antibiotics and hormone combined with external therapy of traditional Chinese medicine. Evaluation of curative effect: observe the score of TCM syndrome and clinical efficacy before and after treatment. Determine the serum level of Hs-CRPN, prolactin, PRL, before and after treatment, and determine the serum levels of Hs-CRPL, prolactin, and prolactin, before and after treatment. After 2 weeks of treatment, the levels of cytokine IL-1 尾 -IL-6 and TNF- 伪 were detected by Elisa. After 2 weeks of treatment, the scores of TCM syndromes in group 2 were significantly decreased compared with those before treatment, and the difference was statistically significant (P 0.01). After treatment, the scores of TCM syndromes in group 2 were significantly lower than those before treatment, and there was a significant difference between the two groups after treatment. The treatment group was superior to the control group. The total effective rate of traditional Chinese medicine for activating blood circulation and detoxification and removing phlegm was 91.67 in the treatment of plasmacytic mastitis, while that of western medicine combined with external treatment of traditional Chinese medicine was 91.67 in the treatment of plasmacytic mastitis, and the total effective rate was 91.67 in the treatment of plasmacytic mastitis by activating blood circulation and detoxifying phlegm. The total effective rate of adenositis was 83.33. After nonparametric test, there was no statistical significance. There was significant difference between the two groups (P < 0.05). There was no significant difference in the level of IL-1 尾 -IL-6TNF- 伪 between the two groups after treatment, and there was no significant difference between the two groups before and after treatment, and there was no significant difference between the two groups in the level of IL-1 尾 -IL-6 and TNF- 伪 after treatment, and there was no significant difference between the two groups before and after treatment. There was significant difference in the mean value of TNF- 伪 between the two groups after treatment. There was a significant difference in the mean value of IL-1 尾 -IL-6 between the two groups (p 0.05). There was no significant difference between the two groups in the cell of abscess stage. 3. The plasma cell mastitis patients were in the abscess stage. The level of IL-6 TNF- 伪 in IL-1 尾 was significantly higher than that in IL-1 尾-6 TNF- 伪 in inflammatory tumor stage, and the level of TNF- 伪 in TNF- 伪 was significantly higher than that in inflammatory tumor. Conclusion the serum Hs-CRP level in patients with plasma cell mastitis can be regarded as one of the reference values to observe the change of the disease. The serum PRL level of the patients with plasma cell mastitis is higher than that of the patients with plasma cell mastitis and the pathogenesis of the disease. The level of serum cytokine, IL-1 尾, IL-6, TNF- 伪 in patients with plasma cell mastitis was significantly higher than that in patients with inflammatory mass at abscess stage. The level of serum cytokine IL-1 尾, IL-6, TNF- 伪 may be related to the degree of inflammation. 4) the method of activating blood circulation and detoxifying and resolving phlegm can relieve the clinical symptoms of patients with plasma cell mastitis, and its mechanism may be related to the decrease of serum IL-1 尾 -IL-6 TNF- 伪 level.
【学位授予单位】：安徽中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R655.8

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